PARIS (AFP) – Millions of cases of dementia could be prevented or delayed by reducing a range of risk factors such as smoking or air pollution, according to a major new study, though outside experts warn that such measures can only go so far.
The debilitating condition, which progressively robs people of their memories, cognitive abilities, language and independence, currently affects over 55 million people across the world.
Dementia is caused by a range of diseases, the most common of which is Alzheimer’s.
A huge review of the available evidence published in The Lancet journal recently said that the “potential for prevention is high” in the fight against dementia.
The study follows a previous report in 2020 that also emphasised the importance of prevention.
At the time, the international team of researchers estimated that 40 per cent of dementia cases were linked to 12 risk factors.
The factors included people having a lower level of education, hearing problems, high blood pressure, smoking, obesity, depression, physical inactivity, diabetes, excessive drinking, traumatic brain injury, air pollution and social isolation. The latest update adds two more risk factors: vision loss and high cholesterol. “Nearly half of dementias could theoretically be prevented by eliminating these 14 risk factors,” the study said.
Decades of research and billions of dollars have failed to produce a cure or truly effective drug for dementia.
But since the start of last year, two Alzheimer’s treatments have been approved in the United States (US): Biogen’s lecanemab and Eli Lilly’s donanemab.
They work by targeting the build-up of two proteins – tau and amyloid beta – considered to be one of the main ways the disease progresses.
However, the benefits of the drugs remain modest, they have severe side effects, and they are often very expensive.
In contrast to the US, the European Union’s medicine watchdog last week refused to approve lecanemab, and it is still considering donanemab.
Some researchers hope the fact that the new drugs work at all means they will pave the way for more effective treatments in the future.
Others prefer to focus on ways to prevent dementia in the first place.
Neurologist Masud Husain at the United Kingdom’s University of Oxford, said that focusing on risk factors “would be far more cost effective than developing high-tech treatments which so far have been disappointing in their impacts on people with established dementia”.
The Lancet study was welcomed by experts in the field, among whom the importance of prevention is hardly debatable.
However, some said the idea that nearly half of all dementia cases could be prevented should be put in perspective.
It has not been proven that the risk factors directly cause dementia, as the authors of the study acknowledged.